You’re surely aware that the Quality Payment Program (QPP) is the centerpiece of MACRA, the Medicare Access and CHIP Reauthorization Act. MACRA is replacing the much-maligned Sustainable Growth Rate (SGR) process for updating the Medicare Physician Fee Schedule. So far, so good, right?
The QPP calls for physcians in Medicare Part B to choose between the Merit-based Incentive Payment System (MIPS), or in an advanced alternate payment model (APM). The biggest concern I see is the potential to game the system by fudging reporting or excluding certain physicians and patients that don’t fit the criteria for incentive payments, a concern that many healthcare leaders share. A study published online in January in the Annals of Internal Medicine on pay-for-performance programs concluded that P4P “may be associated with improved processes of care in ambulatory settings, but consistently positive associations with improved health outcomes have not been demonstrated in any setting.”
To read the full article, The American Journal of Managed Care.